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Brough L, Skeaff S. Iodine. Adv Nutr 2024; 15:100168. [PMID: 38185218 PMCID: PMC10844808 DOI: 10.1016/j.advnut.2024.100168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- Louise Brough
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North, New Zealand.
| | - Sheila Skeaff
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Abdalla AE, Altahir AM, Hasabo EA, Alrawa SS, Elazrag AM, Ahmed HA, Ali HA, Abdelrazig IM, Ahmed MY, Alagib MA, Siddig MM, Asmally RS, Mohamedelrasheed SM, Elnaiem WA, Malik EM. Prevalence and determinants of goitre among children of South Kordofan state, Sudan, 2021: an urgent need for effective implementation of universal salt iodisation. Public Health Nutr 2023; 27:e18. [PMID: 38095122 PMCID: PMC10830365 DOI: 10.1017/s1368980023002744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVE This study aimed to determine the prevalence and determinants of goitre among children aged 6-12 years at South Kordofan state. DESIGN This was a cross-sectional facility-based study. SETTING The study was conducted in twenty villages of South Kordofan state during a medical mission. PARTICIPANTS All 575 school-age children (6-12 years) who attended the medical day were examined for clinical assessment of goitre. RESULTS The prevalence of goitre among children of South Kordofan was 42·8 % (grade 1: 15·7 %, grade 2: 27·1 %). Only 24·2 % of caregivers reported using iodised salt. Mothers working as farmers (OR: 3·209, CI 95 % 1·437, 7·167; P = 0·004) and children of Darforian tribes (OR: 21·799, CI 95 % 2·566, 185·226; P = 0·005) were found to be significantly associated with higher prevalence of goitre among children. This contrasts with children of African tribes, where they were found to have less goitre prevalence (OR: 0·432, CI 95 % 0·213, 0·875; P = 0·02). Iodised salt utilisation (OR = 0·523, CI 95 % 0·320, 0·854; P = 0·01) was found associated with a lower prevalence of goitre. CONCLUSION Even though National Iodine Deficiency Disorders control programs were initiated in Sudan more than 25 years ago, the prevalence of goitre among children in South Kordofan state was alarming (42·8 %). Efforts to improve access to iodised salt, increase utilisation and raise awareness are urgently needed.
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Affiliation(s)
- Azza Elfadil Abdalla
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Anfal Mahmoud Altahir
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Elfatih A. Hasabo
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- CORRIB Research Centre for Advanced Imaging and Core Laboratory, Clinical Science Institute, University of Galway, Galway, Ireland
- Discipline of Cardiology, Saolta Healthcare Group, Health Service Executive, Galway University Hospital, Galway, Ireland
| | - Salma Salah Alrawa
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Amna Mutasim Elazrag
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Hayat Abdoallah Ahmed
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Hiba Abubakr Ali
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ibrahim Mysara Abdelrazig
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Mohamed Yaser Ahmed
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Mohamed Alsiddig Alagib
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Musab Mohammed Siddig
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Rofida Salah Asmally
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Walaa Abdulgadir Elnaiem
- Khartoum Medical Student’s Association, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Elfatih Mohammed Malik
- Community Medicine Department, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Milner D, Boyle F, McNulty J, Knerr I. Assessment of Dietary Intake of Iodine and Risk of Iodine Deficiency in Children with Classical Galactosaemia on Dietary Treatment. Nutrients 2023; 15:nu15020407. [PMID: 36678278 PMCID: PMC9860822 DOI: 10.3390/nu15020407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/24/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Abstract
Iodine is an essential mineral required for the synthesis of thyroid hormones. Iodine plays a critical role in growth and neurocognitive development. Classical galactosaemia is a disorder resulting from an inborn error in galactose metabolism. Its current management consists of life-long lactose and galactose dietary restriction. This study estimated dietary intakes of iodine in infants and children with classical galactosaemia in the Republic of Ireland. The diets of 43 participants (aged 7 months-18 years) with classical galactosaemia were assessed for iodine intake using an iodine-specific food frequency questionnaire. Intakes were compared to the European Food Safety Authority (EFSA) dietary recommendations for iodine intake. The potential role of iodine fortification of dairy alternative products was also examined. There were no significant differences observed between sex, ethnicity and parental education and meeting dietary iodine recommendations. Differences, however, were seen between age groups, causing the p value to approach statistical significance (p = 0.06). Infants consuming infant formula were likely to meet iodine recommendations. However, over half (53%) of children aged 1-18 years had average intakes below the recommendations for age. For these children, consumption of iodine-fortified dairy alternative milk was the leading source of iodine in the diets, followed by fish/shellfish and eggs. An assessment of iodine intake should be undertaken during dietetic reviews for those with classical galactosaemia. Mandatory iodine fortification of all dairy alternative products would result in 92% of the total population cohort meeting iodine recommendations based on their current consumption.
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Affiliation(s)
- Dearbhla Milner
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, D04 V2P1 Dublin, Ireland
| | - Fiona Boyle
- Department of Nutrition and Dietetics, National Centre for Inherited Metabolic Disorders, Children’s Health Ireland, Temple Street, D01 XD99 Dublin, Ireland
- Correspondence:
| | - Jenny McNulty
- Department of Nutrition and Dietetics, National Centre for Inherited Metabolic Disorders, Children’s Health Ireland, Temple Street, D01 XD99 Dublin, Ireland
| | - Ina Knerr
- National Centre for Inherited Metabolic Disorders, Children’s Health Ireland, Temple Street, D01 XD99 Dublin, Ireland
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Yusufali R, Frohmann D, Chuko T, Laillou A. The advancement of Ethiopia's salt iodization programme-The success story of the central iodized facilities. Matern Child Nutr 2022:e13427. [PMID: 36172881 DOI: 10.1111/mcn.13427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 06/16/2023]
Abstract
The objective of this article is to characterize the value of centralized iodization facilities (CIFs) to advance Ethiopia's salt iodization programme and its impact on the population iodine status. The analysis is based on a review of publications relating to salt iodization and iodine deficiency control efforts in Ethiopia. The country has made remarkable progress in improving iodized salt coverage, leading to improved iodine intake across its population that would otherwise be at high risk of iodine deficiency disorders. Establishment of central processing facilities, more frequent monitoring and generation of data and encouraging private sector investment have been instrumental in this achievement. Ethiopia has thus achieved and sustained greater than 89% HH iodized salt coverage from its lowest point of 15% coverage and subsequently improved iodine intake across its population. Iodine intake sufficiency in a population is assessed by median urinary iodine concentration (MUIC). The lessons learned and the experience with CIFs have applicability in several other countries where fragmented salt production continues to create barriers to achieve higher iodized salt coverage.
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Mathiaparanam S, Nori de Macedo A, Mente A, Poirier P, Lear SA, Wielgosz A, Teo KK, Yusuf S, Britz-Mckibbin P. The Prevalence and Risk Factors Associated with Iodine Deficiency in Canadian Adults. Nutrients 2022; 14:nu14132570. [PMID: 35807751 PMCID: PMC9268597 DOI: 10.3390/nu14132570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/04/2023] Open
Abstract
Iodine is a trace micronutrient that is critical for normal thyroid function and human health. Inadequate dietary intake is associated with cognitive impairment, infertility, growth retardation and iodine deficiency disorders in affected populations. Herein, we examined the prevalence of iodine deficiency in adults (median age of 61 years) based on the analysis of 24 h urine samples collected from 800 participants in four clinical sites across Canada in the Prospective Urban and Rural Epidemiological (PURE) study. Urinary iodide together with thiocyanate and nitrate were measured using a validated capillary electrophoresis assay. Protective/risk factors associated with iodine deficiency were identified using a binary logistic regression model, whereas daily urinary iodine concentration (24 h UIC, μg/L) and urinary iodine excretion (24 h UIE, μg/day) were compared using complementary statistical methods with covariate adjustments. Overall, our Canadian adult cohort had adequate iodine status as reflected by a median UIC of 111 μg/L with 11.9% of the population <50 μg/L categorized as having moderate to severe iodine deficiency. Iodine adequacy was also evident with a median 24 h UIE of 226 μg/day as a more robust metric of iodine status with an estimated average requirement (EAR) of 7.1% (< 95 μg/day) and a tolerable upper level (UL) of 1.8% (≥1100 μg/day) based on Canadian dietary reference intake values. Participants taking iodine supplements (OR = 0.18; p = 6.35 × 10−5), had greater 24 h urine volume (OR = 0.69; p = 4.07 × 10−4), excreted higher daily urinary sodium (OR = 0.71; p = 3.03 × 10−5), and/or were prescribed thyroxine (OR = 0.33; p = 1.20 × 10−2) had lower risk for iodine deficiency. Self-reported intake of dairy products was most strongly associated with iodine status (r = 0.24; p = 2.38 × 10−9) after excluding for iodine supplementation and T4 use. Participants residing in Quebec City (OR = 2.58; p = 1.74 × 10−4) and Vancouver (OR = 2.54; p = 3.57 × 10−4) were more susceptible to iodine deficiency than Hamilton or Ottawa. Also, greater exposure to abundant iodine uptake inhibitors from tobacco smoking and intake of specific goitrogenic foods corresponded to elevated urinary thiocyanate and nitrate, which were found for residents from Quebec City as compared to other clinical sites. Recent public health policies that advocate for salt restriction and lower dairy intake may inadvertently reduce iodine nutrition of Canadians, and further exacerbate regional variations in iodine deficiency risk.
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Affiliation(s)
- Stellena Mathiaparanam
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.); (A.N.d.M.)
| | - Adriana Nori de Macedo
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.); (A.N.d.M.)
- Departamento de Química, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Andrew Mente
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON L8L 2X2, Canada; (A.M.); (K.K.T.); (S.Y.)
| | - Paul Poirier
- Faculté de Pharmacie, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC G1V 4G5, Canada;
| | - Scott A. Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby and Division of Cardiology, Providence Health Care, Vancouver, BC V5A 1S6, Canada;
| | - Andreas Wielgosz
- University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada;
| | - Koon K. Teo
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON L8L 2X2, Canada; (A.M.); (K.K.T.); (S.Y.)
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON L8L 2X2, Canada; (A.M.); (K.K.T.); (S.Y.)
| | - Philip Britz-Mckibbin
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.); (A.N.d.M.)
- Correspondence:
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Giri B, Pandey S, Shakya S, Neupane BB, Kandel KP, Yadav CK, Yadav RP, Neupane BP, Gc RB, Saud PS, Yonjan M. Excessive iodine in iodized household salt in Nepal. Ann N Y Acad Sci 2022; 1514:166-173. [PMID: 35611772 DOI: 10.1111/nyas.14793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Iodine is an essential trace element required for the regulation of physiological processes involving the thyroid gland. However, inadequate and excessive intake of iodine are responsible for health problems, such as iodine deficiency disorders, hypothyroidism, hyperthyroidism, thyroiditis, thyroid papillary cancer, and thyrotoxicosis. The Universal Salt Iodization (USI) program has become successful in providing supplemental iodine at the population level globally. Packaging quality, fortification level, and transportation and storage conditions of iodized salt determine the availability of iodine. Previous studies have reported severe health issues caused by excessive iodine intake after the implementation of the USI program. To understand the levels of iodine, we collected 2117 household salt samples from seven districts of Nepal and tested them for iodine content; among them, 98.1% were iodized. Overall median concentration of iodine was 53.9 ppm (range: 43.5-61.4 ppm). The majority (67.2%) of samples had iodine in the range of 45-75 ppm. Approximately 0.9% of samples had inadequate, 13.3% contained adequate, and 83.9% had excessive iodine than the World Health Organization-recommended value. Iodine content varied among the sampling districts and seasons, to some extent. Our study confirmed that iodized salt is widely used in Nepal and is excessively iodized. Excessive intake of iodine through iodized salt requires further attention by policy makers. The iodine level may need adjustment to address the health impact.
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Affiliation(s)
- Basant Giri
- Center for Analytical Sciences, Kathmandu Institute of Applied Sciences, Kathmandu, Nepal
| | - Shishir Pandey
- Center for Analytical Sciences, Kathmandu Institute of Applied Sciences, Kathmandu, Nepal
| | - Sadiksha Shakya
- Center for Analytical Sciences, Kathmandu Institute of Applied Sciences, Kathmandu, Nepal
| | - Bhanu Bhakta Neupane
- Center for Analytical Sciences, Kathmandu Institute of Applied Sciences, Kathmandu, Nepal.,Central Department of Chemistry, Tribhuvan University, Kathmandu, Nepal
| | | | | | | | - Bishnu Prasad Neupane
- Faculty of Health Sciences, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
| | | | - Prem Singh Saud
- Kailali Multiple Campus, Far-western University, Kailali, Nepal
| | - Meghraj Yonjan
- Amrit Science Campus, Tribhuvan University, Kathmandu, Nepal
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Affiliation(s)
- A Olivieri
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Responsible for the Italian National Observatory for Monitoring Iodine Prophylaxis, Rome, Italy.
| | - F Giorgino
- Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Past President of the Italian Society of Endocrinology, University of Bari Aldo Moro, Bari, Italy
| | - C Maffeis
- Department of Surgical Sciences, Dentistry, Paediatrics and Gynaecology, President of the Italian Society of Pediatric Endocrinology and Diabetology, University of Verona, Verona, Italy
| | - M Bagnasco
- Department of Internal Medicine and Medical Specialties, President-elect of the Italian Thyroid Association, University of Genoa, Genoa, Italy
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Iacone R, Iaccarino Idelson P, Russo O, Donfrancesco C, Krogh V, Sieri S, Macchia PE, Formisano P, Lo Noce C, Palmieri L, Galeone D, Rendina D, Galletti F, Di Lenarda A, Giampaoli S, Strazzullo P. Iodine Intake from Food and Iodized Salt as Related to Dietary Salt Consumption in the Italian Adult General Population. Nutrients 2021; 13:nu13103486. [PMID: 34684487 PMCID: PMC8537510 DOI: 10.3390/nu13103486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/19/2022] Open
Abstract
Since the Italian iodoprophylaxis strategy is based on the use of iodized salt, we assessed the relationship between dietary salt consumption and iodine intake in the Italian adult population. We estimated the relative contribution given by the use of iodized salt and by the iodine introduced by foods to the total iodine intake. The study population included 2219 adults aged 25-79 years (1138 men and 1081 women) from all Italian regions, participating to the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008-2012 (OEC/HES), and examined for sodium and iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary sodium and total iodine intake were assessed by the measurement of 24 h urinary excretion, while the EPIC questionnaire was used to evaluate the iodine intake from food. Sodium and iodine intake were significantly and directly associated, upon accounting for age, sex, and BMI (Spearman rho = 0.298; p < 0.001). The iodine intake increased gradually across quintiles of salt consumption in both men and women (p < 0.001). The European Food Safety Authority (EFSA) adequacy level for iodine intake was met by men, but not women, only in the highest quintile of salt consumption. We estimated that approximately 57% of the iodine intake is derived from food and 43% from salt. Iodized salt contributed 24% of the total salt intake, including both discretionary and non-discretionary salt consumption. In conclusion, in this random sample of the Italian general adult population examined in 2008-2012, the total iodine intake secured by iodized salt and the iodine provision by food was insufficient to meet the EFSA adequate iodine intake.
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Affiliation(s)
- Roberto Iacone
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
- Correspondence: (R.I.); (P.I.I.)
| | - Paola Iaccarino Idelson
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
- Correspondence: (R.I.); (P.I.I.)
| | - Ornella Russo
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
| | - Chiara Donfrancesco
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.D.); (C.L.N.); (L.P.)
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (V.K.); (S.S.)
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20133 Milano, Italy; (V.K.); (S.S.)
| | - Paolo Emidio Macchia
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
| | - Pietro Formisano
- Department of Translational Medical Science, Federico II University of Naples Medical School, 80131 Naples, Italy;
| | - Cinzia Lo Noce
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.D.); (C.L.N.); (L.P.)
| | - Luigi Palmieri
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy; (C.D.); (C.L.N.); (L.P.)
| | - Daniela Galeone
- Italian Ministry of Health, Center for Disease Prevention and Control, 00161 Rome, Italy;
| | - Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
| | - Andrea Di Lenarda
- ANMCO, Italian Association of Hospital Cardiology, 50121 Florence, Italy;
- Cardiovascular Center, University Hospital and Health Services, 34122 Trieste, Italy
| | - Simona Giampaoli
- Former Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, Federico II University of Naples Medical School, 80131 Naples, Italy; (O.R.); (P.E.M.); (D.R.); (F.G.); (P.S.)
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Abbag FI, Abu-Eshy SA, Mahfouz AA, Alsaleem MA, Alsaleem SA, Patel AA, Mirdad TM, Shati AA, Awadalla NJ. Iodine Deficiency Disorders as a Predictor of Stunting among Primary School Children in the Aseer Region, Southwestern Saudi Arabia. Int J Environ Res Public Health 2021; 18:7644. [PMID: 34300095 PMCID: PMC8307288 DOI: 10.3390/ijerph18147644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To investigate the present occurrence of stunting and explore the role of iodine deficiency disorders (IDDs) as a predictor of stunting among primary school children in the Aseer Region. METHODS In a cross-sectional investigation on school children in the Aseer region, thyroid enlargement was evaluated clinically. Urine was collected to evaluate iodine content. RESULTS The present study involved 3046 school-age pupils. The study disclosed a total goiter rate of 24.0% (95% CI: 22.5-25.5%). The median urinary iodine content (UIC) was 17.0 µg/L. A prevalence of stunting (height for age z score of less than -2) of 7.8% (95% CI: 6.9-8.8%) was found. In a logistic regression model, pupils having clinical goiter (aOR = 1.739; 95% CI: 1.222-2.475) and students having UIC of less than 17 µg/L (aOR = 1.934; 95% CI: 1.457-2.571) were considerably related with stunting. In the receiver operating characteristic (ROC) curve, urinary iodine content to forecast stunting was good (AUC = 0.611, 95% CI: 0.594-0.629). The curve recognized the optimum cutoff point of urinary iodine content to be ≤19.0 µg/L. The sensitivity was 59.66% (95% CI: 53.1-66.0) and the specificity was 57.62% (95% CI: 55.8-59.5). Conclusion: The present study showed that stunting among school-aged children presents a mild public health problem. On the other hand, a severe iodine deficiency situation was revealed among school children in the Aseer region. Continuous monitoring of iodine status among school children is therefore necessary. Concerted interventions that blend nutrition-sensitive with nutrition-specific approaches are expected to influence decreasing stunting significantly.
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Affiliation(s)
- Fuad I. Abbag
- Department of Child Health, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (F.I.A.); (A.A.S.)
| | - Saeed A. Abu-Eshy
- Department of Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | - Ahmed A. Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.A.A.); (S.A.A.); (N.J.A.)
| | - Mohammed A. Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.A.A.); (S.A.A.); (N.J.A.)
| | - Safar A. Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.A.A.); (S.A.A.); (N.J.A.)
| | - Ayyub A. Patel
- Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | - Tarek M. Mirdad
- Department of Orthopedics, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | - Ayed A. Shati
- Department of Child Health, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (F.I.A.); (A.A.S.)
| | - Nabil J. Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.A.A.); (S.A.A.); (N.J.A.)
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Iacone R, Iaccarino Idelson P, Formisano P, Russo O, Lo Noce C, Donfrancesco C, Macchia PE, Palmieri L, Galeone D, di Lenarda A, Giampaoli S, Strazzullo P. Iodine Intake Estimated by 24 h Urine Collection in the Italian Adult Population: 2008-2012 Survey. Nutrients 2021; 13:1529. [PMID: 34062834 DOI: 10.3390/nu13051529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/16/2022] Open
Abstract
Monitoring the population iodine status is essential for iodine deficiency eradication. This study assessed the average dietary iodine intake and the iodine status of a random sample of the Italian general adult population. The study population included 2378 adults aged 35–79 years (1229 men and 1149 women) from all 20 Italian regions, participating in the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and were examined for iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary iodine intake was assessed by the measurement of 24 h urinary iodine excretion. The median daily iodine intake of the whole population was lower (96 µg/d, interquartile range 51–165) than the daily adequate iodine intake according to both EFSA and WHO recommendation (150 µg/d), with a significantly lower value among women (85 µg/d) compared with men (111 µg/d). Iodine intake diminished with age and increased with BMI (body mass index) in male but not in female participants, without achieving the adequate intake in any sex, age, or BMI category. In this random sample of Italian general adult population examined in 2008–2012, iodine intake still remained lower than the recommended values despite the implementation of a strategy of iodoprophylaxis based on salt iodization in 2005. These data represent a valuable reference for future monitoring of iodine status in our country.
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Schaffner M, Rochau U, Stojkov I, Qerimi Rushaj V, Völzke H, Marckmann G, Lazarus JH, Oberaigner W, Siebert U. Barriers Against Prevention Programs for Iodine Deficiency Disorders in Europe: A Delphi Study. Thyroid 2021; 31:649-657. [PMID: 32912084 DOI: 10.1089/thy.2020.0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Although substantial progress has been made in recent decades in eliminating iodine deficiency, iodine deficiency disorders (IDDs) are still prevalent in European countries. Challenges include ineffective public health programs and discontinuation of IDD prevention. However, the barriers against the implementation and continuation of prevention and monitoring of IDD remain unclear. Therefore, the objective of our study was to identify potential barriers against pan-European IDD prevention and monitoring programs and to find solutions for the different challenges. Methods: We conducted a Delphi study consisting of three rounds. We identified potential participants with expertise and experience in relevant fields from all European countries, including policy makers, health care professionals, health scientists, and patient representatives. The Delphi method was conducted with open-ended questions and item ranking to achieve group consensus on potential barriers against national and pan-European IDD prevention and monitoring programs and related solutions to overcome those barriers. The answers of the Delphi rounds were analyzed using qualitative content analysis and descriptive analysis methods. In addition, we conducted two expert interviews to analyze and discuss the study results. Results: Eighty experts from 36 countries and different fields of work participated in the first Delphi round, 52 in the second, and 46 in the third. Potential barriers include challenges in the fields of knowledge and information, implementation and management, communication and cooperation, political support, and differences between the European countries. Ranked solutions addressing these barriers include cooperation with different stakeholders, gaining knowledge, sharing information, the development of a European program with national specification, European guidelines/recommendations, and European monitoring. The ranking gives a first overview as to which of these barriers would need to be solved most urgently and which solutions may be most helpful. Conclusion: In our study, we derived key information and first insights with regard to barriers against IDD prevention programs from a broad range of stakeholders. Most barriers were found in the category of implementation and management. Also a lack of political support seems to play an important role. The findings of our study may help decision makers in health policy to develop more effective IDD prevention and monitoring strategies.
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Affiliation(s)
- Monika Schaffner
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Ursula Rochau
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Igor Stojkov
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Vjollca Qerimi Rushaj
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
- Faculty of Pharmacy, School of PhD Studies, Ss. Cyril and Methodius University, Skopje, Macedonia
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Georg Marckmann
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - John H Lazarus
- Thyroid Research Group, Cardiff University Medical School, University Hospital of Wales, Cardiff, United Kingdom
| | - Wilhelm Oberaigner
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Uwe Siebert
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
- Department of Health Policy and Management, Center for Health Decision Science, Harvard Chan School of Public Health, Boston, Massachusetts, USA
- Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Nazeri P, Shab-Bidar S, Pearce EN, Shariat M. Do maternal urinary iodine concentration or thyroid hormones within the normal range during pregnancy affect growth parameters at birth? A systematic review and meta-analysis. Nutr Rev 2021; 78:747-763. [PMID: 31923312 DOI: 10.1093/nutrit/nuz105] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
CONTEXT Iodine, an essential constituent of thyroid hormones, is required for proper growth and development. OBJECTIVE To investigate whether growth parameters at birth are associated with maternal urinary iodine concentration (UIC) or normal ranges of thyroid hormones during pregnancy. DATA SOURCES Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, electronic databases (namely, MEDLINE, Web of Science, the Cochrane Library, Scopus, and Google Scholar) were searched between January 1988 and November 2018 to identify relevant articles. DATA EXTRACTION Data from the studies included were independently extracted by 2 investigators using standardized forms developed for this review. DATA ANALYSIS The pooled mean birth weight, length, and head circumference values, and 95% confidence intervals were estimated in newborns born to women with UIC < 150 and UIC ≥150 μg/L during pregnancy. Possible linear or nonlinear associations between maternal UIC and the aforementioned anthropometric measures were evaluated. A narrative synthesis of the data was performed for thyroid hormones with levels within the normal range. RESULTS Of the 123 studies identified, 11 were eligible for inclusion in the meta-analysis. The pooled mean birth weight, length, and head circumference in newborns whose mothers had UIC < 150 μg/L vs UIC ≥150 μg/L were 2898 g vs 2900 g (P = 0.970), 49.6 cm vs 49.4 cm (P = 0.880), and 34.0 cm vs 34.1 cm (P = 0.933), respectively. Dose-response meta-analyses revealed no significant linear or nonlinear associations between maternal UIC during pregnancy and anthropometric measures at birth. Among the different thyroid function parameters evaluated, high-normal values of maternal free thyroxine and thyrotropin during pregnancy were inversely associated with neonatal birth weight. CONCLUSION This systematic review showed that birth weight may be affected by even mild variations in the normal concentrations of maternal thyroid hormones. However, in the current meta-analysis, birth anthropometric measures were not associated with maternal UIC during pregnancy.
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Affiliation(s)
- Pantea Nazeri
- Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Elizabeth N Pearce
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mamak Shariat
- Family Health Institute, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Schaffner M, Mühlberger N, Conrads-Frank A, Qerimi Rushaj V, Sroczynski G, Koukkou E, Heinsbaek Thuesen B, Völzke H, Oberaigner W, Siebert U, Rochau U. Benefits and Harms of a Prevention Program for Iodine Deficiency Disorders: Predictions of the Decision-Analytic EUthyroid Model. Thyroid 2021; 31:494-508. [PMID: 32847437 DOI: 10.1089/thy.2020.0062] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Iodine deficiency is one of the most prevalent causes of intellectual disability and can lead to impaired thyroid function and other iodine deficiency disorders (IDDs). Despite progress made on eradicating iodine deficiency in the last decades in Europe, IDDs are still prevalent. Currently, evidence-based information on the benefit/harm balance of IDD prevention in Europe is lacking. We developed a decision-analytic model and conducted a public health decision analysis for the long-term net benefit of a mandatory IDD prevention program for the German population with moderate iodine deficiency, as a case example for a European country. Methods: We developed a decision-analytic Markov model simulating the incidence and consequences of IDDs in the absence or presence of a mandatory IDD prevention program (iodine fortification of salt) in an open population with current demographic characteristics in Germany and with moderate ID. We collected data on the prevalence, incidence, mortality, and quality of life from European studies for all health states of the model. Our primary net-benefit outcome was quality-adjusted life years (QALYs) predicted over a period of 120 years. In addition, we calculated incremental life years and disease events over time. We performed a systematic and comprehensive uncertainty assessment using multiple deterministic one-way sensitivity analyses. Results: In the base-case analysis, the IDD prevention program is more beneficial than no prevention, both in terms of QALYs and life years. Health gains predicted for the open cohort over a time horizon of 120 years for the German population (82.2 million inhabitants) were 33 million QALYs and 5 million life years. Nevertheless, prevention is not beneficial for all individuals since it causes additional hyperthyroidism (2.7 million additional cases). Results for QALY gains were stable in sensitivity analyses. Conclusions: IDD prevention via mandatory iodine fortification of salt increases quality-adjusted life expectancy in a European population with moderate ID, and is therefore beneficial on a population level. However, further ethical aspects should be considered before implementing a mandatory IDD prevention program. Costs for IDD prevention and treatment should be determined to evaluate the cost effectiveness of IDD prevention.
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Affiliation(s)
- Monika Schaffner
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
| | - Nikolai Mühlberger
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
| | - Annette Conrads-Frank
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
| | - Vjollca Qerimi Rushaj
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
- Faculty of Pharmacy, School of PhD Studies, Ss. Cyril and Methodius University in Skopje, Skopje, Macedonia
| | - Gaby Sroczynski
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
| | - Eftychia Koukkou
- Department of Endocrinology, University of Patras, Patras, Greece
| | | | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Wilhelm Oberaigner
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
| | - Uwe Siebert
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
- Center for Health Decision Science, Department of Health Policy and Management, Harvard Chan School of Public Health, Boston, Massachusetts, USA
- Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ursula Rochau
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria
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Tekalegn Y, Bekele K, Sahiledengle B, Woldeyohannes D. Prevalence of Goiter Among School-Aged Children in Ethiopia: Update of Systematic Review and Meta-analysis. Glob Adv Health Med 2021; 10:2164956120988660. [PMID: 33598366 PMCID: PMC7863155 DOI: 10.1177/2164956120988660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 11/23/2022] Open
Abstract
Background Iodine deficiency is a major public health concern throughout the world. Goiter is the most visible sign of iodine deficiency. In Ethiopia, a study finding regarding the prevalence of goiter among school-age children is inconsistent and highly variable. Objectives To estimate the pooled prevalence of goiter among school-age children in Ethiopia. Methods Three international databases (MEDLINE/Pub-Med, Google Scholar and Science Direct) were systematically searched. Besides, the reference sections of identified articles were searched to increase the chance of detecting missed articles in gray literature. STATA Version 14 statistical software was used to conduct a meta-analysis. The pooled prevalence with a 95% confidence interval was displayed using the forest plot. A random-effect meta-analysis model was used to compute the pooled prevalence, and The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. Results A total of 14 studies fulfilled the inclusion criteria and included in this systematic review and Meta-analysis, with a total sample size of 26,282. The finding of this systematic review revealed that the pooled prevalence of goiter among school-age children was 42.9% (95% CI: 38.8–46.9). The highest prevalence of goiter (46.7%) was observed in Oromia region and the lowest (26.3%) was observed in Benishangul-Gumuz region. Conclusions This review finding revealed that more than two in five of the school children in Ethiopia suffer from iodine deficiency disorder as manifested by the goiter rate.
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Affiliation(s)
- Yohannes Tekalegn
- Department of Public Health, School of Health Science, Goba Referral Hospital, Madda Walabu University, Bale Robe, Ethiopia
| | - Kebebe Bekele
- Department of Surgery, School of Medicine, Goba Referral Hospital, Madda Walabu University, Bale Robe, Ethiopia
| | - Biniyam Sahiledengle
- Department of Public Health, School of Health Science, Goba Referral Hospital, Madda Walabu University, Bale Robe, Ethiopia
| | - Demelash Woldeyohannes
- Department of Public Health, School of Health Science, Goba Referral Hospital, Madda Walabu University, Bale Robe, Ethiopia
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Abstract
Background: Literature to date has been inconclusive regarding the value of thyroglobulin (Tg) as a marker of iodine status in pregnant women. This systematic review and meta-analysis is one of the first to assess whether Tg concentration accurately reflects iodine status among pregnant women. Methods: We searched MEDLINE, the Web of Science, the Cochrane Library, Scopus, and other relevant databases to identify relevant studies published in the English language, between January 1988 and December 2018. The criteria for study inclusion in the systematic review were human studies, healthy pregnant women as participants, and available data for maternal urinary iodine concentration (UIC) and Tg level. Each study was assessed for quality and risk of bias. The pooled mean Tg values, and 95% confidence intervals were estimated in a population of women with UIC <150 and UIC ≥150 μg/L during pregnancy. Potential linear or nonlinear dose-response associations between maternal UIC and Tg concentration were examined. Results: Of 814 identified studies, 25 were eligible for inclusion in the meta-analysis. Studies included were conducted in Africa, Asia, Europe, South America, and the Oceania. The pooled mean (95% confidence interval [CI]) Tg concentration in iodine-deficient pregnant women was higher than that in iodine-sufficient pregnant women (10.73 μg/L [5.65-15.82] vs. 7.34 μg/L [2.20-12.47]); a comparison of the 95% CI showed that none of these values was significantly different. No significant differences were observed in Tg concentration between the two groups in each trimester of pregnancy. Dose-response meta-analyses revealed a significant nonlinear association between maternal UIC and Tg concentration during pregnancy. Among populations of pregnant women, an inverse association was found between UIC values <100 μg/L and Tg concentration (p-linearity = 0.007; p-nonlinearity = 0.027); however, higher values of UIC were not associated with Tg concentration. Conclusions: Our meta-analysis showed that Tg concentration can be a sensitive indicator of iodine deficiency, specifically in populations of pregnant women with median UIC <100 μg/L. Further studies are warranted to determine the sensitivity of Tg at different degrees of iodine deficiency during pregnancy.
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Affiliation(s)
- Pantea Nazeri
- Family Health Institute, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Mamak Shariat
- Family Health Institute, Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Yao N, Zhou C, Xie J, Li X, Zhou Q, Chen J, Zhou S. Assessment of the iodine nutritional status among Chinese school-aged children. Endocr Connect 2020; 9:379-386. [PMID: 32365330 PMCID: PMC7219133 DOI: 10.1530/ec-19-0568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/15/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The remarkable success of iodine deficiency disorders (IDD) elimination in China has been achieved through a mandatory universal salt iodization (USI) program. The study aims to estimate the relationship between urinary iodine concentration (UIC) and iodine content in edible salt to assess the current iodine nutritional status of school aged children. METHODS A total of 5565 students from 26 of 39 districts/counties in Chongqing participated in the study, UIC and iodine content in table salt were measured. Thyroid volumes of 3311 students were examined by ultrasound and goiter prevalence was calculated. RESULTS The overall median UIC of students was 222 μg/L (IQR: 150-313 μg/L). Median UIC was significantly different among groups with non-iodized salt (iodine content <5 mg/kg), inadequately iodized salt (between 5 and 21 mg/kg), adequately iodized (between 21 and 39 mg/kg) and excessively iodized (>39 mg/kg) salt (P < 0.01). The total goiter rate was 1.9% (60/3111) and 6.0% (186/3111) according to Chinese national and WHO reference values, respectively. Thyroid volume and goiter prevalence were not different within the three iodine nutritional status groups (insufficient, adequate and excessive, P > 0.05). CONCLUSIONS The efficient implementation of current USI program is able to reduce the goiter prevalence in Chongqing as a low incidence of goiter in school aged children is observed in this study. The widened UIC range of 100-299 μg/L indicating sufficient iodine intake is considered safe with a slim chance of causing goiter or thyroid dysfunction. Further researches were needed to evaluate the applicability of WHO reference in goiter diagnose in Chongqing or identifying more accurate criteria of normal thyroid volume of local students in the future.
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Affiliation(s)
- Ning Yao
- Chongqing Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Chunbei Zhou
- Chongqing Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Jun Xie
- Chongqing Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Xinshu Li
- Chongqing Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Qianru Zhou
- Chongqing Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Jing Chen
- Chongqing Center for Disease Control and Prevention, Chongqing, People’s Republic of China
| | - Shuang Zhou
- Chongqing Center for Disease Control and Prevention, Chongqing, People’s Republic of China
- Correspondence should be addressed to S Zhou:
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Baldini E, Virili C, D'Armiento E, Centanni M, Ulisse S. Iodine Status in Schoolchildren and Pregnant Women of Lazio, a Central Region of Italy. Nutrients 2019; 11:nu11071647. [PMID: 31323889 PMCID: PMC6683099 DOI: 10.3390/nu11071647] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/10/2019] [Accepted: 07/16/2019] [Indexed: 12/25/2022] Open
Abstract
The inhabitants of Lazio, similarly to those of other Italian regions, have been historically exposed to the detrimental effects of an inadequate intake of iodine. The latter is a micronutrient essential for the biosynthesis of thyroid hormones (TH). Iodine deficiency is responsible for a number of adverse effects on human health known as iodine deficiency disorders (IDD), the most common of which worldwide are goiter and hypothyroidism. In order to reduce IDD, a national salt iodination program was started in Italy in 2005. In this article we reviewed the available data regarding iodine intake in the Lazio population before and after the introduction of the national salt iodination program, in order to evaluate its efficacy and the eventual problem(s) limiting its success. On the whole, the information acquired indicates that, following the introduction of the program, the dietary iodine intake in the Lazio population is improved. There is, however, still much work ahead to ameliorate the iodine prophylaxis in this region. In fact, although a generally adequate iodine intake in school-age children has been observed, there are still areas where a mild iodine insufficiency is present. Moreover, two independent epidemiological surveys on pregnant women evidenced a low urinary iodine concentration with respect to the reference range conceived by the World Health Organization. These findings demonstrate the need for greater attention to the iodine prophylaxis by health care providers (i.e., obstetricians, gynecologists, pediatricians, etc.), and the implementation of effective advertising campaigns aimed at increasing the knowledge and awareness of the favorable effects of iodine supplementation on population health.
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Affiliation(s)
- Enke Baldini
- Department of Surgical Sciences, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Camilla Virili
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, 04100 Latina, Italy
| | - Eleonora D'Armiento
- Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, 00161 Rome, Italy
| | - Marco Centanni
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, 04100 Latina, Italy
| | - Salvatore Ulisse
- Department of Surgical Sciences, "Sapienza" University of Rome, 00161 Rome, Italy.
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Bhattacharya U, Chandra AK. Socioeconomic status of the population - a prime determinant in evaluating iodine nutritional status even in a post salt iodization scenario. J Pediatr Endocrinol Metab 2019; 32:143-149. [PMID: 30710486 DOI: 10.1515/jpem-2018-0344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 12/16/2018] [Indexed: 11/15/2022]
Abstract
Background To compare the state of iodine nutrition among school age children (SAC) in high- (HSGs) and low-socioeconomic groups (LSGs) during a post iodation scenario in Kolkata. Methods Clinical examinations of the goiter, median urinary iodine (MUI), mean urinary thiocyanate (MUSCN) in SAC (6-12 years) from both sexes in the different socioeconomic groups were carried out and the iodine content of edible salt was measured. Results A total of 5315 SAC, of which 2875 SAC were from a HSG and another 2440 SAC from an LSG were clinically examined for goiter. In the HSGs the total goiter prevalence (TGP) was 3.2% and in the LSGs the TGP was 9.1% and the difference was statistically significant (p<0.001). The MUI of the HSGs was 242 μg/L as compared to 155 μg/L in the LSGs (p<0.001). MUSCN of the HSGs was 0.77±0.45 mg/dL while in the LSGs it was 0.94±0.44 mg/dL and the difference was statistically significant (p<0.01). In the HSGs 19.4% salt samples had 15-30 ppm iodine and 80.6% salt samples were above 30 ppm as compared to 26.3% salt samples which were below 15 ppm, 37.1% salt samples which were between 15 and 30 ppm and 36.6% salt samples which were above 30 ppm in the LSGs. Conclusions The population of the LSGs was clinically mildly iodine deficient having no biochemical iodine deficiency while in the HSGs it was more than the adequate requirement and the HSG children are possibly at risk of excess iodine induced thyroid diseases. Existing goiter prevalence in the LSGs was from their relatively high consumption of dietary goitrogens. Therefore, socioeconomic status plays a pivotal role in the management of iodine nutrition even in a post salt iodation scenario.
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Affiliation(s)
- Udayan Bhattacharya
- Senior Research Fellow, Endocrinology and Reproductive Physiology Laboratory, Department of Physiology, University College of Science and Technology, University of Calcutta, Kolkata, West Bengal, India
| | - Amar K Chandra
- UGC Emeritus Professor, Endocrinology and Reproductive Physiology Laboratory, Department of Physiology, University College of Science and Technology, University of Calcutta, 92, A.P.C. Road, Kolkata - 700 009, West Bengal, India
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Abstract
BACKGROUND Milk is a major source of iodine in human nutrition. Because both iodine content and the consumption of milk and dairy vary widely over time and populations, their contribution to iodine intake must be evaluated regularly. A recent national iodine survey found Israel's population to be mildly iodine deficient, possibly due to unmonitored changes in the food content of dietary iodine. Accounting for dairy iodine content can help guide efforts to prevent iodine deficiency. OBJECTIVES This study aimed to determine the iodine concentration of dairy products typically consumed in the Israeli diet, and to estimate iodine intake from dairy products among Israeli adults. METHODS Iodine was analyzed in 33 selected dairy products that account for 89% of the total population's dairy intake according to the "MABAT" Israeli National Health and Nutrition survey. Based on these data, the distribution of iodine intake from milk, dairy, and dairy-based foods in the adult population was calculated. RESULTS Israeli milk is rich in iodine, with a mean concentration of 22 μg/100 g. However, due to low dairy consumption, the mean iodine intake from milk and dairy was only 34 μg/day (median 23 μg/day; range: 0-337 μg/day) or 22% of the recommended daily allowance. Self-reported intake among poor, male, and Arab subgroups was even lower. CONCLUSIONS Because Israeli milk and dairy products are iodine rich, their contribution to the population's iodine intake would increase if they were consumed in greater amounts, particularly by high-risk groups. Dairy's potential contribution to iodine nutrition should be considered in recommendations for dairy consumption and iodine prophylaxis.
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Affiliation(s)
- Yaniv S Ovadia
- 1 Nutrition and Brain Health Laboratory, School of Nutritional Sciences and Institute of Biochemistry, Food Science, and Nutrition, The Hebrew University of Jerusalem , Rehovot, Israel
- 2 Department of Internal Medicine "C, " Barzilai University Medical Center Ashkelon , Ashkelon, Israel
| | - Dov Gefel
- 2 Department of Internal Medicine "C, " Barzilai University Medical Center Ashkelon , Ashkelon, Israel
| | - Nathalie Weizmann
- 1 Nutrition and Brain Health Laboratory, School of Nutritional Sciences and Institute of Biochemistry, Food Science, and Nutrition, The Hebrew University of Jerusalem , Rehovot, Israel
| | - Merav Raizman
- 1 Nutrition and Brain Health Laboratory, School of Nutritional Sciences and Institute of Biochemistry, Food Science, and Nutrition, The Hebrew University of Jerusalem , Rehovot, Israel
| | - Rebecca Goldsmith
- 3 Nutrition Department, Israel Ministry of Health , Jerusalem, Israel
| | - Sameer J Mabjeesh
- 4 Department of Animal Science, Robert H. Smith Faculty of Agriculture, Food, and Environment, The Hebrew University of Jerusalem , Rehovot, Israel
| | - Lisbeth Dahl
- 5 Institute of Marine Research (IMR) , Bergen, Norway
| | - Aron M Troen
- 1 Nutrition and Brain Health Laboratory, School of Nutritional Sciences and Institute of Biochemistry, Food Science, and Nutrition, The Hebrew University of Jerusalem , Rehovot, Israel
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Knowles J, van der Haar F, Shehata M, Gerasimov G, Bimo B, Cavenagh B, Maramag CC, Otico E, Izwardy D, Spohrer R, Garrett GS. Iodine Intake through Processed Food: Case Studies from Egypt, Indonesia, the Philippines, the Russian Federation and Ukraine, 2010-2015. Nutrients 2017; 9:nu9080797. [PMID: 28933750 PMCID: PMC5579591 DOI: 10.3390/nu9080797] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/17/2017] [Accepted: 07/20/2017] [Indexed: 11/16/2022] Open
Abstract
The current performance indicator for universal salt iodisation (USI) is the percentage of households using adequately iodised salt. However, the proportion of dietary salt from household salt is decreasing with the increase in consumption of processed foods and condiments globally. This paper reports on case studies supported by the Global Alliance for Improved Nutrition (GAIN)-UNICEF USI Partnership Project to investigate processed food industry use of adequately iodised salt in contrasting national contexts. Studies were conducted in Egypt, Indonesia, the Philippines, the Russian Federation, and Ukraine. In all cases, the potential iodine intake from iodised salt in selected food products was modelled according to the formula: quantity of salt per unit of food product × minimum regulated iodine level of salt at production × average daily per capita consumption of the product. The percent of adult recommended nutrient intake for iodine potentially provided by the average daily intake of bread and frequently consumed foods and condiments was from 10% to 80% at the individual product level. The potential contribution to iodine intake from the use of iodised salt in the processed food industry is of growing significance. National USI strategies should encourage co-operative industry engagement and include regulatory monitoring of iodised salt use in the food industry in order to achieve optimal population iodine status.
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Affiliation(s)
- Jacky Knowles
- Large Scale Food Fortification Initiative, Global Alliance for Improved Nutrition, 1202 Geneva, Switzerland.
| | | | - Magdy Shehata
- Nutrition/Food Technology, United Nations, World Food Programme, Cairo, Egypt.
| | | | - Bimo Bimo
- Large Scale Food Fortification Initiative, Global Alliance for Improved Nutrition, Jakarta 12950, Indonesia.
| | | | - Cherry C Maramag
- Research and Program Unit, Nutrition Center of the Philippines, Muntinlupa City 1780, Philippines.
| | - Edward Otico
- Large Scale Food Fortification Initiative, Global Alliance for Improved Nutrition, Manila 1000, Philippines.
| | - Doddy Izwardy
- Community Nutrition, Indonesia Ministry of Health, Jakarta 12950, Indonesia.
| | - Rebecca Spohrer
- Large Scale Food Fortification Initiative, Global Alliance for Improved Nutrition, 1202 Geneva, Switzerland.
| | - Greg S Garrett
- Large Scale Food Fortification Initiative, Global Alliance for Improved Nutrition, 1202 Geneva, Switzerland.
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Li R, Liu HP, Hong CL, Dai ZX, Liu JW, Zhou J, Hu CQ, Weng HX. Iodide and iodate effects on the growth and fruit quality of strawberry. J Sci Food Agric 2017; 97:230-235. [PMID: 26992053 DOI: 10.1002/jsfa.7719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 03/05/2016] [Accepted: 03/13/2016] [Indexed: 05/08/2023]
Abstract
BACKGROUND Iodine deficiency is an environmental health problem affecting one-third of the global population. An iodine biofortification hydroponic experiment was conducted to explore the iodide and iodate uptake characteristics of strawberry plants, to measure the dosage effects of iodine on plant growth and to evaluate the influence of I- or IO3- application on fruit quality. RESULTS After biofortification, the iodine contents of the fresh strawberry fruits were 600-4000 µg kg-1 , covering the WHO dietary iodine allowance of 150 µg · day-1 for adults. The iodine uptake of the strawberry plants increased with increasing I- or IO3- concentration of the culture solution. At the same iodine concentration, the iodate uptakes of various plant organs under I- treatments were apparently more than those under IO3- treatments. Low-level exogenous iodine (I- ≤ 0.25 mg L-1 or IO3- ≤ 0.50 mg L-1 ) not only promoted plant growth and increased biomass per plant, but also improved fruit quality by enhancing the vitamin C and soluble sugar contents of the strawberry fruits. Nevertheless, excessive exogenous iodine inhibited plant growth and reduced biomass per plant. IO3- uptake apparently increased the total acidity and nitrate content of the fruits, reducing the quality of the strawberry fruits. Conversely, I- uptake obviously decreased the total acidity and nitrate content of the strawberry fruits, improving the fruit quality. CONCLUSION The strawberry can be used as a target crop for iodine biofortification. Furthermore, applying an appropriate dose of KI can improve the fruit quality of the strawberry plants. © 2016 Society of Chemical Industry.
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Affiliation(s)
- Rui Li
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Geological Research Center for Agricultural Application, China Geological Survey, Hangzhou 311201, Zhejiang, China
| | - Hui-Ping Liu
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Chun-Lai Hong
- Zhejiang Academy of Agricultural Sciences, Hangzhou 310021, Zhejiang, China
| | - Zi-Xi Dai
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Jia-Wei Liu
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Jun Zhou
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Chun-Qing Hu
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Huan-Xin Weng
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
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Doggui R, El Ati-Hellal M, Traissac P, Lahmar L, El Ati J. Adequacy Assessment of a Universal Salt Iodization Program Two Decades after Its Implementation: A National Cross-Sectional Study of Iodine Status among School-Age Children in Tunisia. Nutrients 2016; 9:E6. [PMID: 28029137 PMCID: PMC5295050 DOI: 10.3390/nu9010006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/05/2016] [Accepted: 11/10/2016] [Indexed: 12/13/2022] Open
Abstract
In the framework of a worldwide policy to eliminate iodine deficiency (ID) disorders, universal salt iodization was adopted in Tunisia two decades ago. The present study aims to evaluate this strategy, using both performance and impact indicators. A total of 1560 children, aged 6-12 years, were randomly sampled using a national, two-stage, stratified, cross-sectional cluster survey in 2012. Urinary iodine concentration (UIC) of the subjects, and household salt iodine content, were analyzed. The national median UIC was 220 µg/L (95% confidence interval (CI): 199-241), indicating an acceptable iodine status at the population level. Only 11.4% (95% CI: 8.6-14.9) of the children had UIC <100 µg/L, but with large regional disparities (4.3% to 25.5%, p < 0.01); however, more than a quarter of the subjects were at risk of adverse health consequences due to iodine excess. Children from households of low socio-economic levels were more prone to inadequate UIC. The national median iodine concentration of household salt was 22 mg/kg (95% CI: 21-23). Only half of the households used adequately iodized salt (15-25 ppm), with large regional disparities. National ID rates are now well below the target criteria of WHO (World Health Organization) certification (<20% of children with UIC <50 µg/L and <50% with UIC <100 µg/L). The coverage of adequately iodized salt fell short in meeting the goals of USI (Universal Salt Iodization), i.e., >90% of households. Regular monitoring of iodized salt production lines must be strengthened with involvement by producers.
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Affiliation(s)
- Radhouene Doggui
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 Rue Jebel Lakhdar, babSaadoun, Tunis 1007, Tunisia.
| | - Myriam El Ati-Hellal
- Institut Préparatoire aux Etudes Scientifiques et Techniques, Toxicology Research and Environment Research Laboratory, 10, Rue Abou El KacemChabbi, Montfleury, Tunis 1008, Tunisia.
| | - Pierre Traissac
- IRD (Institut de Recherche pour le Développement), NUTRIPASS Unit, IRD-UM-SupAgro, 911, Av Agropolis, 534394 Montpellier CEDEX, France.
| | - Lilia Lahmar
- Hôpital d'Enfants, Pediatric Radiology Department, Bab Saadoun, Tunis 1007, Tunisia.
| | - Jalila El Ati
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, 11 Rue Jebel Lakhdar, babSaadoun, Tunis 1007, Tunisia.
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Abstract
INTRODUCTION Uttarakhand (UK) state is a known endemic region for Iodine deficiency. OBJECTIVE To assess iodine nutritional status among adolescent girls in districts: Udham Singh Nagar (USN), Nainital (N) and Pauri (P) of UK state. METHODS In each district, 30 clusters (schools) were identified by using population proportionate to size cluster sampling. In each school, 60 girls (12-18 years) attending the schools were included. Total of 5430 girls from USN (1823), N (1811) and P (1796) were studied. Clinical examination of thyroid of each girl was conducted. From each cluster, spot urine and salt samples were collected. RESULTS Total goiter rate was found to be 6.8% (USN), 8.2% (N) and 5.6% (P). Median urinary iodine concentration levels were 250 μg/l (USN), 200 μg/l (N) and 183 μg/l (P). CONCLUSION Findings of the study documented that adolescent girls had adequate iodine nutritional status in the three districts of UK.
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Affiliation(s)
- Umesh Kapil
- Department of Human Nutrition, All India Institute of Medical Sciences, New Delhi-110029, India
| | - Neha Sareen
- Department of Foods and Nutrition, The Maharaja Sayajirao University of Baroda, Vadodara-390002, Gujarat, India
| | - Vanisha S Nambiar
- Department of Foods and Nutrition, The Maharaja Sayajirao University of Baroda, Vadodara-390002, Gujarat, India
| | - Preetika Khenduja
- Department of Human Nutrition, All India Institute of Medical Sciences, New Delhi-110029, India
| | - Nighat Yaseen Sofi
- Department of Human Nutrition, All India Institute of Medical Sciences, New Delhi-110029, India
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Abstract
OBJECTIVE To contribute evidence relevant to the policy of supplying iodised salt (IS), non-iodised salt (NIS) or both in Chinese cities. DESIGN Subnational telephone interview survey. SETTING China. PARTICIPANTS Totally, 24 557 telephone numbers were dialled and 4833 citizens accepted the telephone interview. The telephone numbers were randomly selected by random digit dialling and a Mitofsky-Waksberg two-stage sampling method in 17 capital cities and 6 coastal cities from 17 iodine deficiency disorder (IDD)-eliminated provinces (municipalities). RESULTS The 4833 citizens finished the telephone interview. Among them, 3738 (77.3%) citizens chose IS, 481 (10%) citizens chose NIS, and the others chose both IS and NIS. The citizens' awareness rates of IDD and IDD preventive measures were 68.7% and 62.5%, respectively. CONCLUSIONS It is not a suitable time to supply IS and NIS simultaneously in the developed cities of China, but a pilot project may be conducted in the cities where IDD has been sustainably eliminated, there is strong awareness of IDD and the population can make informed decisions regarding IS. IDD health education should be further strengthened, especially regarding the potential for IQ damage.
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Affiliation(s)
- J Yu
- Institute for Kaschin-Beck Disease Control, the Centre for Endemic Disease Control, Harbin Medical University, Harbin, People's Republic of China
| | - P Liu
- Institute for Iodine Deficiency Disorders, the Centre for Endemic Disease Control, Harbin Medical University, Harbin, People's Republic of China
| | - Y Liu
- Institute for Iodine Deficiency Disorders, the Centre for Endemic Disease Control, Harbin Medical University, Harbin, People's Republic of China
| | - S J Liu
- Institute for Iodine Deficiency Disorders, the Centre for Endemic Disease Control, Harbin Medical University, Harbin, People's Republic of China
| | - D J Sun
- The Centre for Endemic Disease Control, Harbin Medical University, Harbin, People's Republic of China. Key lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health, Harbin, China
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Shriraam V, Mahadevan S, Anitharani M, Selvavinayagam, Sathiyasekaran B. National health programs in the field of endocrinology and metabolism - Miles to go. Indian J Endocrinol Metab 2014; 18:7-12. [PMID: 24701424 PMCID: PMC3968736 DOI: 10.4103/2230-8210.126521] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The endocrine and metabolic diseases of childhood obesity, diabetes mellitus, hypertension, iodine deficiency disorders, vitamin D deficiency, and osteoporosis are major public health problems. Different programs including National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke address these problems although some are yet to be addressed. National surveys have shown high prevalence of these disorders and their risk factors. Most of the programs aim at awareness raising, lifestyle modification, (primary prevention) and screening (secondary prevention) for the disease conditions as these are proven to be cost-effective compared to late diagnosis and treatment of various complications. Urgent concerted full scale implementation of these programs with good coordination under the umbrella of National Rural Health Mission is the need of the moment. The referral system needs strengthening as are the secondary and tertiary levels of health care. Due attention is to be given for implementation of these programs in the urban areas, as the prevalence of these conditions is almost equal or even higher among urban poor people where primary and secondary prevention measures are scarcely available and treatment costs are sky-high.
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Affiliation(s)
- Vanishree Shriraam
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Porur, Tamil Nadu, India
| | - Shriraam Mahadevan
- Department of Endocrinology and Diabetes, Sri Ramachandra Medical College and Research Institute, Porur, Tamil Nadu, India
| | - M Anitharani
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Porur, Tamil Nadu, India
| | - Selvavinayagam
- Tamil Nadu Health Systems Project, Directorate of Public Health, Government of Tamil Nadu, Tamil Nadu, India
| | - Bwc Sathiyasekaran
- Department of Community Medicine, Sri Ramachandra Medical College and Research Institute, Porur, Tamil Nadu, India
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Pandav CS, Yadav K, Srivastava R, Pandav R, Karmarkar M. Iodine deficiency disorders (IDD) control in India. Indian J Med Res 2013; 138:418-33. [PMID: 24135192 PMCID: PMC3818611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Iodine deficiency disorders (IDD) constitute the single largest cause of preventable brain damage worldwide. Majority of consequences of IDD are invisible and irreversible but at the same time these are preventable. In India, the entire population is prone to IDD due to deficiency of iodine in the soil of the subcontinent and consequently the food derived from it. To combat the risk of IDD, salt is fortified with iodine. However, an estimated 350 million people do not consume adequately iodized salt and, therefore, are at risk for IDD. Of the 325 districts surveyed in India so far, 263 are IDD-endemic. The current household level iodized salt coverage in India is 91 per cent with 71 per cent households consuming adequately iodized salt. The IDD control goal in India was to reduce the prevalence of IDD below 10 per cent in the entire country by 2012. What is required is a "mission approach" with greater coordination amongst all stakeholders of IDD control efforts in India. Mainstreaming of IDD control in policy making, devising State specific action plans to control IDD, strict implementation of Food Safety and Standards (FSS) Act, 2006, addressing inequities in iodized salt coverage (rural-urban, socio-economic), providing iodized salt in Public Distribution System, strengthening monitoring and evaluation of IDD programme and ensuring sustainability of IDD control activities are essential to achieve sustainable elimination of IDD in India.
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Affiliation(s)
- Chandrakant S. Pandav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India,Reprint requests: Dr Chandrakant S. Pandav, Professor & Head, Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110 029, India e-mail:
| | - Kapil Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Srivastava
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rijuta Pandav
- Department of Social & Behavioral Sciences, School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - M.G. Karmarkar
- Department of Indian Coalition for Control of Iodine Deficiency Disorders, New Delhi, India
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Patro BK, Saboth P, Zodpey S, Shukla A, Karmarkar MG, Pandav CS. Tracking progress toward elimination of iodine deficiency disorders in jharkhand, India. Indian J Community Med 2013; 33:182-5. [PMID: 19876480 PMCID: PMC2763680 DOI: 10.4103/0970-0218.42061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Accepted: 04/10/2008] [Indexed: 11/18/2022] Open
Abstract
Research question: What is the current status of Iodine Deficiency Disorders (IDD) in the state of Jharkhand? Objectives: (1) To determine the status of iodine deficiency in the state. (2) To determine the availability and cost of adequately iodized salt at the retail shops. (3) To study the perceptions of the community regarding iodine deficiency, salt and iodized salt. Design: A cross-sectional community-based survey. Study setting: Thirty clusters selected through the probability proportion to size (PPS) sampling in the state of Jharkhand. Study participants: Children aged 6-12 years, households, retail shopkeepers and opinion leaders. Study tool: Quantitative and qualitative methodology using a pretested questionnaire and focus group discussion used to carry out the community-based survey. Results: Total goiter rate (TGR) was 0.9%. Median urinary iodine level was 173.2 µg/L. The proportion of individuals with urinary iodine levels less than 100 and 50 µg/L were 26.4% and 10%, respectively. Slightly less than two-thirds (64.2%) of the households were found to be consuming adequately iodized salt as measured by titration (greater than 15 ppm). Iodized salt was available across the state and the cost varied between Re. 1 and Rs. 8 per kilogram. A common belief among the community was that iodized salt is equivalent to refined packet salt that is further equivalent to expensive salt. Conclusion: The results of the present survey show that the iodine nutrition in the state of Jharkhand is optimal. Considering that the consumption of adequately iodized salt should increase from 64.2% to the goal of more than 90%, sustained efforts are required in this place to consolidate the current coverage of adequately iodized salt and increase it to greater than 90%.
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Affiliation(s)
- Binod Kumar Patro
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi - 110 029, India
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Purwanti A, Fitra S, Utari A, Susanto R. The effects of stimulation intervention on speech development of children 1-3 years old in Iodine Deficiency Disorders (IDD) area. Int J Pediatr Endocrinol 2013. [PMCID: PMC3850144 DOI: 10.1186/1687-9856-2013-s1-p148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Asri Purwanti
- Department of Pediatric, Faculty of Medicine, Diponegoro University/ Dr. Kariadi Hospital, Semarang, Indonesia
| | - Saldi Fitra
- Department of Pediatric, Faculty of Medicine, Diponegoro University/ Dr. Kariadi Hospital, Semarang, Indonesia
| | - Agustini Utari
- Department of Pediatric, Faculty of Medicine, Diponegoro University/ Dr. Kariadi Hospital, Semarang, Indonesia
| | - Rudy Susanto
- Department of Pediatric, Faculty of Medicine, Diponegoro University/ Dr. Kariadi Hospital, Semarang, Indonesia
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Mahfouz MS, Gaffar AM, Bani IA. Iodized salt consumption in Sudan: present status and future directions. J Health Popul Nutr 2012; 30:431-438. [PMID: 23304909 PMCID: PMC3763614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Iodine Deficiency Disorders (IDD) Control Programme in Sudan adopted salt iodization as the long-term strategy in 1994. In 2000, it was found that less than 1% of households were using adequately-iodized salt. The objectives of this study were to: (i) study the coverage and variation of different geographical regions of Sudan regarding access to and use of iodized salt, (ii) explore the possible factors which influence the use of iodized salt, (iii) develop recommendations to help in the implementation of the Universal Salt Iodization (USI) strategy in Sudan. This paper is based on the Sudan Household Health Survey (SHHS) dataset. A total sample of 24,507 households was surveyed, and 18,786 cooking salt samples were tested for iodine levels with rapid salt-testing kits. Nationally, the percentage of households using adequately-iodized salt increased from less than 1% in 2000 to 14.4%, with wide variations between states. Access to iodized salt ranged from 96.9% in Central Equatoria to 0.4% in Gezira state. Population coverage with iodized salt in Sudan remains very low. The awareness and political support for USI programme is very weak. National legislation banning the sale of non-iodized salt does not exist. Utilization of the already-existing laws, like the National Standardization and Metrology Law (2008), to develop a compulsory national salt specification, will accelerate the USI in Sudan.
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Affiliation(s)
- Mohamed Salih Mahfouz
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.
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Buxton C, Baguune B. Knowledge and practices of people in Bia District, Ghana, with regard to iodine deficiency disorders and intake of iodized salt. Arch Public Health 2012; 70:5. [PMID: 22958618 PMCID: PMC3415111 DOI: 10.1186/0778-7367-70-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 03/23/2012] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Despite numerous educational programmes to create awareness about iodized salt and iodine deficiency disorders (IDD), a survey conducted in the Western Region of Ghana in 2007 revealed that the goitre rate stood at 18.8%; and 78.1% of households consumed iodized salt, which is below the goal of the IDD programme in Ghana which aimed at 90% household consumption of iodized salt by the end of 2005 and sustaining the gains by 2011. It was therefore, considered timely to investigate the knowledge levels and the extent of utilization of iodized salt among the people living in Bia District, the District with the lowest intake (77.4%) of iodized salt based on findings of the 2007 survey. METHODS This was a descriptive cross-sectional study. It was conducted among a total of 280 household members, mainly in charge of meal preparation, who were interviewed using a structured interview guide. A combination of cluster and simple random sampling techniques was used to select the respondents from all the seven sub- districts in Bia District. RESULTS The study revealed that 75.6% of households in the district consumed iodized salt (including households described as occasional users of iodized salt), and knowledge of iodized salt was quite high, as 72% of the respondents knew that not every salt contained iodine. In addition, 69.3% indicated that an inadequate intake of iodized salt can lead to the development of goitre. Despite the high awareness level, only 64.6% of respondents indicated that they exclusively used iodized salt for cooking. The main reason given by exclusive users of common salt was that the price of iodized salt is a little higher than that of common salt. CONCLUSIONS Although majority of the respondents are aware of the importance of iodized salt and iodine deficiency disorders, only 64.6% exclusively used iodized salt, suggesting that respondents' high knowledge levels did not necessarily translate into an increase in the number of households who used iodized salt. Existing laws and policies on universal salt iodization and quality assurance of iodized salt from the production stage to the distribution/selling stage should be enforced.
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Affiliation(s)
- Christiana Buxton
- Department of Science and Mathematics Education (Health Sciences Education Programme), Faculty of Education, University of Cape Coast, Ghana
| | - Benjamin Baguune
- District Health Directorate, Ghana Health Services, P. O. Box 29, Essam, Western Region, Ghana
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Abstract
Hypothyroxinemia with low levels of circulating free thyroxine and normal levels of thyrotropin, which is usually caused by iodine deficiency, may affect pregnant women even in apparently iodine-sufficient areas, and it is debated whether it increases the risk of neurodevelopmental abnormalities in children born to them. Epidemiological observations indeed indicate that this is the case. Animal models show abnormal brain cortical cytoarchitecture in pups born to mildly hypothyroxinemic dams. In regions where the availability and use of iodized salt is inadequate (where <90% of households use iodized salt), the WHO and the International Council for Control of Iodine Deficiency Disorders (ICCIDD) recommend iodine supplementation so that the total iodine intake is 250 µg/day to prevent iodine deficiency during gestation and lactation.
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Affiliation(s)
- Pere Berbel
- a Instituto de Neurociencias, Universidad Miguel Hernández-CSIC, Campus de Sant Joan, Apartado de Correos 18, Sant Joan d'Alacant, 03550 Alicante, Spain.
| | - Juan Bernal
- b Instituto de Investigaciones Biomédicas, CSIC-UAM, Centro de Investigación Biomédica en Enfermedades Raras, CIBERER, Arturo Duperier 4, 28029 Madrid, Spain
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